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Abraar Karan Profile picture
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29 Mar, 5 tweets, 3 min read
Hoping for less deadly surges

1/ An important piece of the puzzle that some have pointed to: 49% of 65+ in our country have been *fully vaxx*; 73% have received at least 1 dose

We know age is single most significant risk factor in mortality. #covid19

covid.cdc.gov/covid-data-tra…
2/ While proposed plans to simply isolate the elderly are largely unachievable/ not how societies fundamentally function-- what many of us do agree on is that vaccinating the elderly as a priority group is critical; and we are doing it well.

cdc.gov/coronavirus/20…
3/ With real world data from @CDCMMWR today showing significant protection even 2 weeks after just the 1st dose of mRNA vaccines, I am optimistic that we should see a further notable reduction in mortality even w/ subsequent #covid19 surges

4/ One caveat here is that the data from that study was among first responders/frontline workers, so majority were under 50 YO; 28% reportedly above 50 YO

But, we have seen sig declines also reported in data from nursing homes last month

nytimes.com/interactive/20…
5/ There are obvious other factors that are at play, so don't want to over-simplify this either; contributions of variants being one.

But-- our vaccines are excellent; our vaccine rollout is picking up real steam. Need focus on equity + continued mitigation measures #covid19

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More from @AbraarKaran

Abraar Karan Profile picture
29 Mar
Excellent news from @CDCMMWR today!

Under real-world conditions, vaccine effectiveness of mRNA (Moderna, Pfizer) vaccines:
-90% after 2 doses
-80% after one dose (both measured 14 days after dose) #covid19

cdc.gov/mmwr/volumes/7…
2/ "Prospective cohorts of 3,950 health care personnel, first responders, and other essential and frontline workers completed weekly SARS-CoV-2 testing for 13 consecutive weeks."

Data collected from eight U.S. locations during December 14, 2020–March 13, 2021 #covid19
3/ "CDC routinely tested for SARS-CoV-2 infections every week regardless of symptom status and at the onset of symptoms consistent with COVID-19–associated illness."

Gets at one of the biggest questions since the vaccines came out: extent of reduction in asymptomatic cases
Read 6 tweets
Abraar Karan Profile picture
29 Mar
1/ The key bottleneck to scaling mRNA vaccines is a "worldwide shortage of essential components... nucleotides, enzymes, & lipids", according to this piece.

But...companies that can do this are not licensing their manufacturing so that others can join in nature.com/articles/d4158…
2/ So, once again, the issues we are facing are *man-made*

They are issues with how financial incentives overpower global health equity

There are ways that we could scale up more right now; but that won't happen because it threatens wealth

@gregggonsalves @PeterHotez
3/ These are complicated matters. But the system as it stands is not designed for health emergencies: it generates products (i.e. vaccines) for the few who can afford them; everyone else is subject to 'charity'

Even during a pandemic.
#covid19
Read 4 tweets
Abraar Karan Profile picture
28 Mar
1/ As I reflect on the arguments people have put forward regarding individual rights...

Those opposed to masks likely would *not be opposed* (before #covid9) to a restriction of someone coughing/sneezing in your face if they were sick

Yet, we know the logic here is the same
2/ With asymptomatic spread, it doesn’t take coughing/sneezing; it just takes talking/breathing in a public space near others to infect them

So- the rules of the game haven’t changed here

Your right to do certain things is still limited by how they harm other people
3/ Yet their seems to be a perception/misperception that having people wear a mask in public spaces during a respiratory pandemic is somehow a restriction on freedoms

It is not

It is a restriction against harming others

We were never free to do that #covid19
Read 5 tweets
Abraar Karan Profile picture
28 Mar
-The reversal in #covid19 trends in Michigan & the Northeast seen below

~15% or so of the country is vaccinated
~30m confirmed cases from natural infection

-some overlap between those two groups (recovered who got vaxx)

-*many* still susceptible

npr.org/816707182 Image
2/ Seroprevalence studies also indicate that we are under-detecting cases based on discordance b/w rtPCR and antibody studies; these numbers have varied at different time points in the year- all the way up to 10x by some measures at some time points #covid19
3/ One of the big questions is to what extent we have underlying immunity from un-detected cases, & to what extent that contributed to rapid declines in case numbers in January/Feb. Even so, that wouldn't be the whole story; physical distancing & other control measures matter.
Read 10 tweets
Abraar Karan Profile picture
27 Mar
Was interviewed for this @NPRGoatsandSoda piece on how pandemics exacerbate racism & xenophobia; these are not new forces- they constantly are brewing underneath & within our day to day lives. They were amplified during a global crisis. #covid19

npr.org/sections/goats…
2/ Also gets into forces within the global health sector that are both remnants and repackagings of our history of colonial exploitation— we need to more deeply reckon with this as US/European based “global health doctors”; during Covid19, many of us paused overseas work.
3/ This is not a criticism against individuals; it is a call to more deeply reconsider what outcomes academic global health systems are designed to create; and whether they are doing enough to promote global health equity. #covid19
Read 7 tweets
Abraar Karan Profile picture
24 Mar
1/ Treated multiple #covid19 cases today.

Only when you hear actual stories of the struggles people are going through does it make it clear how problematic it is when we blame those who got sick because of what externally seems like “irresponsible” behavior.
2/ Caregivers of disabled family members who did not have the luxury to stay home; those working in factories where outbreaks are prevalent; we are still seeing these cases and treating them. This isn’t about lockdowns or no lockdowns- this is about creating better public health.
3/ This is about creating systems that can protect us during crises.

The false choice of lockdowns v no lockdowns has been birthed from politics, not public health.

Why is the idea of an actual public health strategy not being brought up in these debates? #covid19
Read 6 tweets

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